Significant Long-Lasting Improvement after Switch to Incobotulinum Toxin in Cervical Dystonia Patients with Secondary Treatment Failure
Under continuous long-term treatment with abo- or onabotulinum toxin type A (BoNT/A), ~10 to 15% of patients with cervical dystonia (CD) will develop neutralizing antibodies and reduced responsiveness over an ~10-year treatment period. Among the botulinum neurotoxin type A preparations so far licens...
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MDPI AG
2022-01-01
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| Series: | Toxins |
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| Online Access: | https://www.mdpi.com/2072-6651/14/1/44 |
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| author | Harald Hefter Beyza Ürer Raphaela Brauns Dietmar Rosenthal Sven G. Meuth John-Ih Lee Philipp Albrecht Sara Samadzadeh |
| author_facet | Harald Hefter Beyza Ürer Raphaela Brauns Dietmar Rosenthal Sven G. Meuth John-Ih Lee Philipp Albrecht Sara Samadzadeh |
| author_sort | Harald Hefter |
| collection | DOAJ |
| description | Under continuous long-term treatment with abo- or onabotulinum toxin type A (BoNT/A), ~10 to 15% of patients with cervical dystonia (CD) will develop neutralizing antibodies and reduced responsiveness over an ~10-year treatment period. Among the botulinum neurotoxin type A preparations so far licensed for CD, incobotulinum toxin A (incoBoNT/A; Xeomin<sup>®</sup>) is the only one without complex proteins. Whether CD patients with treatment failure under abo- or onaBoNT/A may still respond to incoBoNT/A is unknown. In this cross-sectional, retrospective study, 64 CD patients with secondary treatment failure after abo- or onaBoNT/A therapy who were switched to incoBoNT/A were compared to 34 CD patients exclusively treated with incoBoNT/A. The initial clinical severity of CD, best outcome during abo- or onaBoNT/A therapy, severity at the time of switching to incoBoNT/A and severity at recruitment, as well as all corresponding doses, were analyzed. Furthermore, the impact of neutralizing antibodies (NABs) on the long-term outcome of incoBoNT/A therapy was evaluated. Patients significantly improved after the switch to incoBoNT/A (<i>p</i> < 0.001) but did not reach the improvement level obtained before the development of partial secondary treatment failure or that of patients who were exclusively treated with incoBoNT/A. No difference between abo- and onaBoNT/A pretreatments or between the long-term outcomes of NAB-positive and NAB-negative patients was found. The present study demonstrates significant long-term improvement after a switch to incoBoNT/A in patients with preceding secondary treatment failure after abo- or onaBoNT/A therapy and confirms the low antigenicity of incoBoNT/A. |
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| language | English |
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| publishDate | 2022-01-01 |
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| series | Toxins |
| spelling | doaj.art-d5cc1373da874e499ee78b0dfd5b7d5b2023-11-23T15:36:10ZengMDPI AGToxins2072-66512022-01-011414410.3390/toxins14010044Significant Long-Lasting Improvement after Switch to Incobotulinum Toxin in Cervical Dystonia Patients with Secondary Treatment FailureHarald Hefter0Beyza Ürer1Raphaela Brauns2Dietmar Rosenthal3Sven G. Meuth4John-Ih Lee5Philipp Albrecht6Sara Samadzadeh7Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, GermanyDepartment of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, GermanyDepartment of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, GermanyDepartment of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, GermanyDepartment of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, GermanyDepartment of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, GermanyDepartment of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, GermanyDepartment of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, GermanyUnder continuous long-term treatment with abo- or onabotulinum toxin type A (BoNT/A), ~10 to 15% of patients with cervical dystonia (CD) will develop neutralizing antibodies and reduced responsiveness over an ~10-year treatment period. Among the botulinum neurotoxin type A preparations so far licensed for CD, incobotulinum toxin A (incoBoNT/A; Xeomin<sup>®</sup>) is the only one without complex proteins. Whether CD patients with treatment failure under abo- or onaBoNT/A may still respond to incoBoNT/A is unknown. In this cross-sectional, retrospective study, 64 CD patients with secondary treatment failure after abo- or onaBoNT/A therapy who were switched to incoBoNT/A were compared to 34 CD patients exclusively treated with incoBoNT/A. The initial clinical severity of CD, best outcome during abo- or onaBoNT/A therapy, severity at the time of switching to incoBoNT/A and severity at recruitment, as well as all corresponding doses, were analyzed. Furthermore, the impact of neutralizing antibodies (NABs) on the long-term outcome of incoBoNT/A therapy was evaluated. Patients significantly improved after the switch to incoBoNT/A (<i>p</i> < 0.001) but did not reach the improvement level obtained before the development of partial secondary treatment failure or that of patients who were exclusively treated with incoBoNT/A. No difference between abo- and onaBoNT/A pretreatments or between the long-term outcomes of NAB-positive and NAB-negative patients was found. The present study demonstrates significant long-term improvement after a switch to incoBoNT/A in patients with preceding secondary treatment failure after abo- or onaBoNT/A therapy and confirms the low antigenicity of incoBoNT/A.https://www.mdpi.com/2072-6651/14/1/44secondary treatment failureincobotulinum toxinneutralizing antibodieslow antigenicitycomplex proteins |
| spellingShingle | Harald Hefter Beyza Ürer Raphaela Brauns Dietmar Rosenthal Sven G. Meuth John-Ih Lee Philipp Albrecht Sara Samadzadeh Significant Long-Lasting Improvement after Switch to Incobotulinum Toxin in Cervical Dystonia Patients with Secondary Treatment Failure Toxins secondary treatment failure incobotulinum toxin neutralizing antibodies low antigenicity complex proteins |
| title | Significant Long-Lasting Improvement after Switch to Incobotulinum Toxin in Cervical Dystonia Patients with Secondary Treatment Failure |
| title_full | Significant Long-Lasting Improvement after Switch to Incobotulinum Toxin in Cervical Dystonia Patients with Secondary Treatment Failure |
| title_fullStr | Significant Long-Lasting Improvement after Switch to Incobotulinum Toxin in Cervical Dystonia Patients with Secondary Treatment Failure |
| title_full_unstemmed | Significant Long-Lasting Improvement after Switch to Incobotulinum Toxin in Cervical Dystonia Patients with Secondary Treatment Failure |
| title_short | Significant Long-Lasting Improvement after Switch to Incobotulinum Toxin in Cervical Dystonia Patients with Secondary Treatment Failure |
| title_sort | significant long lasting improvement after switch to incobotulinum toxin in cervical dystonia patients with secondary treatment failure |
| topic | secondary treatment failure incobotulinum toxin neutralizing antibodies low antigenicity complex proteins |
| url | https://www.mdpi.com/2072-6651/14/1/44 |
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